Cynthia Stanford, M.ED., LMFT

Individual provider Active NPI Marriage & Family Therapist · S Burlington, VT

NPI 1861947293 · NPPES record last updated May 22, 2023

Key facts

NPI
1861947293
Entity type
Individual (NPI type 1)
Primary specialty
Marriage & Family Therapist 106H00000X
License
100.0092654 (VT)
Practice address
60 Proctor Ave
S Burlington, VT 05403-6134
Phone
(802) 448-2175
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective Jan 1, 2024 through Jan 1, 2028

National Provider Directory

Medicare enrollment (NPD)
No
Credentials
Master of Education

State licenses

LicenseStateTypeSpecialty
100.0092654VTMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Roots and Branches, PLLC Marriage & Family Therapist Current
since May 28, 2023
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 100.0092654 VT Yes

Addresses

Primary practice location

60 Proctor Ave
S Burlington, VT 05403-6134

Mailing address

60 Proctor Ave
S Burlington, VT 05403-6134

Other providers in S Burlington, VT

All providers in S Burlington, VT · Marriage & Family Therapist in Vermont

Sources for this page

Verify at the official NPI Registry.